MOREHOUSE-EMORY PARTNERSHIP TO REDUCE CV DISPARITIES ? AIM II

莫尔豪斯-埃默里大学合作减少简历差异？

• 批准号: 8173618
• 负责人: PRISCILLA E PEMU
• 金额: $ 12.9万
• 依托单位: MOREHOUSE SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-07-01 至 2011-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8173618
• 关键词: Address; African American; Awareness; Bispecific Antibody 2B1; Caring; Cholesterol; Clinical; Clinical Research; Communities; Community Physician; Computer Retrieval of Information on Scientific Projects Database; Data Collection; Diagnosis; Diet; Dietary Practices; Education; Educational Intervention; Exercise Tolerance; Exhibits; Feedback; Focus Groups; Food; Funding; Grant; Guidelines; Health behavior; High Density Lipoproteins; Hour; Inflammatory; Institution; Insulin; Intervention; Metabolic; Metabolic syndrome; Outcome; Participant; Patients; Pattern; Performance; Phase; Physicians; Pilot Projects; Provider; Psyche structure; Psychosocial Factor; Questionnaires; Randomized; Records; Research; Research Personnel; Resources; Risk Factors; SF-36; Self Efficacy; Self Management; Serum; Social support; Source; Staging; Stress; Structure; Treadmill Tests; Treatment outcome; United States National Institutes of Health; Weight; base; bone; depressive symptoms; expectation; experience; fasting glucose; follow-up; health related quality of life; improved; lifestyle intervention; lipoprotein triglyceride; medication compliance; primary care setting; standardized care; treatment as usual

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. he specific aims of the original proposal were unmodified and remain as follows: Specific Aim 2: To promote physician awareness and patient lifestyle interventions to enhance treatment and outcomes of CV risk factors associated with Metabolic Syndrome in hypertensive African Americans. Specific Aim 2a: To determine the baseline state of awareness, treatment and control of the Metabolic Syndrome among community based practitioners, and provide a physician feedback and education intervention on provider diagnosis and treatment of CV risk factors associated with the Metabolic Syndrome in hypertensive African Americans. We will describe practice patterns in primary care settings, and compare the percentages of hypertensive patients who are treated with JCN7 and ATPIII guidelines and assessed for the Metabolic Syndrome before and after structured performance feedback and education(audit feedback). Specific Aim 2b: To develop and evaluate the effects of a culturally sensitive self management lifestyle intervention (LSI) on health behaviors, clinical outcomes and psychosocial factors in hypertensive AA with CV risk factors associated with the Metabolic Syndrome. 2b1. Primary aim To determine if participants who receive the LSI intervention demonstrate improved health behaviors over participants randomized to usual care (UC) as exhibited by: increased exercise tolerance test (treadmill), increased PA levels (Metabolic Syndrome-h/week from CAPS Questionnaire); improved dietary patterns (Block Questionnaire; 3 day food records), and improved medication compliance (Hill-Bone Questionnaire). 2b2. Secondary aim: To determine if participants who receive the LSI demonstrate improved clinical outcomes over those randomized to UC as exhibited by: lower systolic and diastolic BP, lower weight, improved serum total cholesterol, high density lipoproteins, and triglyceride levels, and improved metabolic and inflammatory profile (fasting glucose, 2 hour glucose, fasting insulin, HOMA, CRP). 2b3. Tertiary aim: To determine if participants who receive the LSI experience improved health related quality of life (HRQOL) and psychosocial factors over those receiving UC as exhibited by improved overall physical and mental functioning (SF-36), lower perceived stress, lower depressive symptoms, increased social support, increased diet and PA self efficacy, and increased stage of change for PA. We proposed to carry out the study in three phases. Phase I involves a detailed assessment of hypertensive care among the Community Physician Network (CPN) practices with efforts made to standardize care. Specific aim 2a is addressed in phase I. In phase II, which addresses aim 2b ( "develop and evaluate a culturally sensitive self-management lifestyle intervention on health behaviors") focus groups to assess concordance of planned intervention to expectations and acceptance, and a pilot study were conducted, Phase III is the clinical study involving recruitment and randomization of patients to usual care or the lifestyle intervention with baseline and follow-up data collection and analysis.

该子项目是利用该技术的众多研究子项目之一 资源由 NIH/NCRR 资助的中心拨款提供。子项目及 研究者 (PI) 可能已从 NIH 的另一个来源获得主要资金， 因此可以在其他 CRISP 条目中表示。列出的机构是 对于中心来说，它不一定是研究者的机构。 原提案的具体目标未作修改，仍如下： 具体目标 2：提高医生意识和患者生活方式干预，以加强与高血压非裔美国人代谢综合征相关的心血管危险因素的治疗和结果。 具体目标 2a：确定社区从业人员对代谢综合征的认识、治疗和控制的基线状态，并就与高血压非裔美国人代谢综合征相关的心血管危险因素的诊断和治疗提供医生反馈和教育干预。我们将描述初级保健机构的实践模式，并比较在结构化绩效反馈和教育（审核反馈）之前和之后接受 JCN7 和 ATPIII 指南治疗并评估代谢综合征的高血压患者的百分比。 具体目标 2b：开发和评估文化敏感的自我管理生活方式干预 (LSI) 对患有代谢综合征相关心血管危险因素的高血压 AA 的健康行为、临床结果和心理社会因素的影响。 2b1.主要目的 确定接受 LSI 干预的参与者是否表现出比随机接受常规护理 (UC) 的参与者改善的健康行为，具体表现如下：运动耐量测试（跑步机）增加、PA 水平增加（来自 CAPS 问卷的代谢综合征 - 小时/周） ;改善饮食模式（集体问卷；3 天食物记录），并提高用药依从性（Hill-Bone 问卷）。 2b2.次要目标：确定接受 LSI 的参与者是否比随机接受 UC 的参与者表现出更好的临床结果，具体表现如下：收缩压和舒张压降低，体重减轻，血清总胆固醇、高密度脂蛋白和甘油三酯水平改善，代谢和甘油三酯水平改善。炎症特征（空腹血糖、2 小时血糖、空腹胰岛素、HOMA、CRP）。 2b3.第三个目标：确定接受 LSI 的参与者是否比接受 UC 的参与者体验到健康相关的生活质量 (HRQOL) 和心理社会因素的改善，表现为整体身心功能的改善 (SF-36)、感知压力的降低、抑郁症状的降低，增加社会支持，增加饮食和 PA 自我效能，并增加 PA 变化阶段。 我们建议分三个阶段进行研究。第一阶段涉及对社区医生网络 (CPN) 实践中的高血压护理进行详细评估，并努力实现护理标准化。具体目标 2a 在第一阶段得到解决。在第二阶段，目标 2b（“制定和评估对健康行为具有文化敏感性的自我管理生活方式干预措施”）焦点小组来评估计划干预措施与期望和接受度的一致性，以及进行了试点研究，第三阶段是临床研究，涉及招募和随机分配患者进行常规护理或生活方式干预，并收集和分析基线和随访数据。